| Dr Thomas Ryan Wallin, MD | |
|
2100 Powell Street, California Emergency Physicians Credentialing Dept, Emeryville, CA 94608 | |
| (888) 267-3880 | |
| Not Available |
| Full Name | Dr Thomas Ryan Wallin |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 2100 Powell Street, Emeryville, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881872034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | A94866 (California) | Primary |
| Entity Name | Cep America - California |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023063542 PECOS PAC ID: 6103739131 Enrollment ID: O20031106000520 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thomas Ryan Wallin, MD 2100 Powell Street, California Emergency Physicians Credentialing Dept, Emeryville, CA 94608 Ph: (888) 267-3880 | Dr Thomas Ryan Wallin, MD 2100 Powell Street, California Emergency Physicians Credentialing Dept, Emeryville, CA 94608 Ph: (888) 267-3880 |
Jeffery J Leinen, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 Powell St Ste 900, Emeryville, CA 94608 Phone: 510-350-2600 | |
Louis P Tran, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2100 Powell St, Suite 900, Emeryville, CA 94608 Phone: 510-350-2600 | |
Kathryn L Hall-boyer, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2100 Powell St Ste 900, Suite 900, Emeryville, CA 94608 Phone: 510-350-2600 Fax: 510-879-9100 | |
Guisou Mahmoud, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 Powell St, Suite 900, Emeryville, CA 94608 Phone: 510-350-2600 | |
John L Hardin, PAC Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2100 Powell St Ste 900, Emeryville, CA 94608 Phone: 510-350-2673 | |
James M Montoya, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 2100 Powell St, Suite 920, Emeryville, CA 94608 Phone: 510-350-2673 Fax: 510-597-9200 | |
Jaron Duane Ross, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2100 Powell St, Suite 940, Emeryville, CA 94608 Phone: 888-883-7362 Fax: 510-879-9100 |